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. 2018 Nov;24(11):2204-2210.
doi: 10.1016/j.bbmt.2018.06.028. Epub 2018 Jun 30.

Translation of Clinical Research into Practice: An Impact Assessment of the Results from the Blood and Marrow Transplant Clinical Trials Network Protocol 0201 on Unrelated Graft Source Utilization

Nandita Khera  1 , Lih-Wen Mau  2 , Ellen M Denzen  2 , Christa Meyer  2 , Kate Houg  2 , Stephanie J Lee  3 , Mary M Horowitz  4 , Linda J Burns  2
Affiliations

Translation of Clinical Research into Practice: An Impact Assessment of the Results from the Blood and Marrow Transplant Clinical Trials Network Protocol 0201 on Unrelated Graft Source Utilization

Nandita Khera et al. Biol Blood Marrow Transplant. 2018 Nov.

Abstract

Barriers and facilitators to adoption of results of clinical trials are substantial and poorly understood. We sought to examine whether the results of the randomized, multicenter Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0201 study comparing peripheral blood (PB) with bone marrow (BM) stem cells for unrelated donor (URD) hematopoietic cell transplantation (HCT) changed practice from PB to BM graft utilization and explored factors that impact graft selection and translation of research results into practice. The difference between use of URD BM and PB in the 2 years before and after publication of results in 2012 was examined using observational data collected by the Center for Blood and Marrow Transplant Research. A web-based survey of transplant physicians was conducted to understand the change in physician-reported personal and center preferred URD graft. No significant change in use of BM versus PB grafts occurred after 2012. Both BMT CTN participating and nonparticipating centers continued to use PB. Ninety-two percent of respondents were aware of the study results; 18% reported a change in personal and 16% reported a change in their center's practice of requesting BM instead of PB for URD HCT. Patient characteristics and the perception that engaging local champions to increase the evidence uptake were factors associated with personal or center change in practice. Despite awareness of the trial results, fewer than one-fifth of HCT physicians reported practice change in response to the BMT CTN 0201 results. Observational data confirmed no discernible change in practice.

Keywords: Evidence-based practice; Hematopoietic cell transplantation; Practice patterns; Randomized clinical trials.

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Conflict of interest statement

Conflict of Interest: The authors have no relevant financial conflicts of interest to disclose.

Figures

Figure 1:
Figure 1:
Trend in utilization of unrelated bone marrow and peripheral blood: 2002-2014
Figure 2:
Figure 2:
Mean percentage of bone marrow utilization in the two years pre- (2010-2011) and post- (2013-2014) publication of BMT CTN 0201 results in 2012 by center participation in BMT CTN 0201
Figure 3:
Figure 3:
Flow Chart of Study Survey Recruitment Abbreviations: ASBMT, American Society of Blood and Marrow Transplantation; US, United States
Figure 4:
Figure 4:
Practice change in preference of unrelated donor graft source from 0201 study by physician preference or physician perceived TC’s preference (N=316*)
See this image and copyright information in PMC

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